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Meng, X.* ; Liu, C.* ; Chen, R.* ; Sera, F.* ; Vicedo-Cabrera, A.M.* ; Milojevic, A.* ; Guo, Y.* ; Tong, S.* ; Coelho, M.S.Z.S.* ; Saldiva, P.H.N.* ; Lavigne, E.* ; Correa, P.M.* ; Ortega, N.V.* ; Osorio, S.* ; Garcia, S.O.* ; Kyselý, J.* ; Urban, A.* ; Orru, H.* ; Maasikmets, M.* ; Jaakkola, J.J.K.* ; Ryti, N.* ; Huber, V.* ; Schneider, A.E. ; Katsouyanni, K.* ; Analitis, A.* ; Hashizume, M.* ; Honda, Y.* ; Ng, C.F.S.* ; Nunes, B.* ; Teixeira, J.P.* ; Holobaca, I.H.* ; Fratianni, S.* ; Kim, H.* ; Tobias, A.* ; Iñiguez, C.* ; Forsberg, B.* ; Åström, C.* ; Ragettli, M.S.* ; Guo, Y.L.* ; Pan, S.C.* ; Li, S.* ; Bell, M.L.* ; Zanobetti, A.* ; Schwartz, J.* ; Wu, T.* ; Gasparrini, A.* ; Kan, H.*

Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities.

BMJ 372:n534 (2021)
Postprint DOI PMC
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
OBJECTIVE: To evaluate the short term associations between nitrogen dioxide (NO2) and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide, using a uniform analytical protocol. DESIGN: Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis. SETTING: 398 cities in 22 low to high income countries/regions. MAIN OUTCOME MEASURES: Daily deaths from total (62.8 million), cardiovascular (19.7 million), and respiratory (5.5 million) causes between 1973 and 2018. RESULTS: On average, a 10 μg/m3 increase in NO2 concentration on lag 1 day (previous day) was associated with 0.46% (95% confidence interval 0.36% to 0.57%), 0.37% (0.22% to 0.51%), and 0.47% (0.21% to 0.72%) increases in total, cardiovascular, and respiratory mortality, respectively. These associations remained robust after adjusting for co-pollutants (particulate matter with aerodynamic diameter ≤10 μm or ≤2.5 μm (PM10 and PM2.5, respectively), ozone, sulfur dioxide, and carbon monoxide). The pooled concentration-response curves for all three causes were almost linear without discernible thresholds. The proportion of deaths attributable to NO2 concentration above the counterfactual zero level was 1.23% (95% confidence interval 0.96% to 1.51%) across the 398 cities. CONCLUSIONS: This multilocation study provides key evidence on the independent and linear associations between short term exposure to NO2 and increased risk of total, cardiovascular, and respiratory mortality, suggesting that health benefits would be achieved by tightening the guidelines and regulatory limits of NO2.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
ISSN (print) / ISBN 0959-8138
e-ISSN 1756-1833
Journal BMJ
Quellenangaben Volume: 372, Issue: , Pages: , Article Number: n534 Supplement: ,
Publisher British Medical Association
Publishing Place London
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology II (EPI2)
Grants Academy of Finland
China Medical Board Collaborating Program
Medical Research Council, UK
Natural Environment Research Council, UK
European Union
Spanish Ministry of Science and Innovation
German Federal Ministry of Education and Research
Environment Research and Technology Development Fund of the Environmental Restoration and Conservation Agency, Japan
Czech Science Foundation
Shanghai Municipal Science and Technology Commission
Career Development Fellowship of the Australian National Health and Medical Research Council
Early Career Fellowship of the Australian National Health and Medical Research Council
National Natural Science Foundation of China